Organization
COSMETIC DENTISTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT LEON JEANMENNE DDS (OWNER, PRESIDENT)
(814) 238-2020
Entity
Organization
Contact information
Practice address
110 RADNOR RD, SUITE 200, STATE COLLEGE, PA 16801-7987
(814) 238-2020
Mailing address
110 RADNOR RD, SUITE 200, STATE COLLEGE, PA 16801-7987
(814) 238-2020
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS035349
PA
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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